Progestin-Only Hormonal Methods (Mini-Pills, Implants, and Shots)
How It Works
birth control methods, including pills (called
"mini-pills"), implants, and shots, prevent the from releasing an egg
(ovulation), thicken mucus at the so sperm cannot enter the , and
in rare cases, prevent a fertilized egg from implanting in the .
Birth control mini-pills
come in a monthly pack. To be effective, the pills must be taken at the same time each day. If you take a pill more than 3 hours late:
- Take it as soon as you remember even if that means you will take 2 pills in one day. Use another method
of for the next 48 hours to prevent .footnote 1
- Consider using
if you have had in the past 3 to 5 days.
The progestin-only implant releases hormones that prevent
thin rod about the size of a matchstick. This is inserted under the skin on the
inside of the upper arm.
- The implant is a highly effective method of .
- The implant must be inserted and removed by a trained health
for 12 to 13 weeks.
Why It Is Used
Progestin-only mini-pills, implants,
and shots are good choices for women who:
- Are breastfeeding. The mini-pill is a good choice for
breastfeeding mothers. It is very low-dose and does not affect the milk
supply. Breastfeeding further reduces the chance of .
- Need short- or long-term
time. (But it may take from 12 weeks to 18 months to become pregnant after stopping the shot.)
that can be stopped at any
- Prefer a form of
that does not interfere with
- Cannot take
than 35; have long-standing, poorly controlled
heart disease; have problems with
blood clots; or have
high blood pressure.
, including those who smoke and are older
migraine headaches with
auras, or women whose migraines get worse when taking
the in combination pills.
- Have heavy, painful menstrual periods.
bleeding and cramping.
anemia from heavy menstrual bleeding.
sickle cell disease. Women with
may have fewer problems from their disease when using the
How Well It Works
Shots and implants are highly
effective methods of .
Progestin-only mini-pills are
very effective, but combination hormone pills are even more effective. Also,
the mini-pill has to be taken at the same time every day to work
This method is highly effective,
unless you fail to get a shot after 3 months.footnote 2
- Typical use: Among all Depo-Provera users, 6 women out of 100
become pregnant each year.
- Perfect use: Of women who get their shots on schedule, fewer than 1 out of 100 become pregnant each year.
This method is very effective,
but you must take the mini-pill at the same time every day.footnote 2
- Typical use: Among all mini-pill users, 9 women out of 100
become pregnant each year.
- Perfect use: Of women who take every mini-pill on schedule,
fewer than 1 out of 100 become pregnant each year.
This method is extremely effective and
lasts for 3 years.footnote 2
- Typical use and perfect use are the same for this method. Fewer than 1 woman out of 100 has an unplanned .
Medicines that can interfere with hormonal birth control
Some combinations of medicine may affect the
your body, making them too strong or too weak. This may increase your chance of
becoming pregnant. Or a new medicine may be less likely to work because you
have hormones in your body. Talk with your doctor or pharmacist
to make sure that the medicines you take are not causing problems when you are
using hormonal .
Most side effects of the progestin-only
methods go away after the first few months of use. Side effects
- Irregular menstrual cycles.
- Spotting or bleeding between menstrual periods.
- Sore breasts.
- Bloating or weight gain, especially with the shot.
- No menstrual periods. Although mini-pill use can stop periods,
the shot is most likely to do so.
Less common progestin side effects include
depression and darkening of the skin on the upper lip,
under the eyes, or on the forehead (chloasma).
Risks of the shot
Bone thinning. Use of the shot for 2 or more years can cause
which may not be fully reversible after stopping the medicine.footnote 3
concern. Teens are normally building bone mass as they grow. This is why it is
very important for teens to get enough calcium and when using
the shot. A small study among teens showed that from the shot
was reversed after the teens stopped getting the shots.footnote 4 Talk to your doctor about your risk if you have been using
the shot for longer than 2 years.
Progestin risk after having gestational diabetes
See Drug Reference for a full list of side effects.
(Drug Reference is not available in all systems.)
What To Think About
Progestin-only mini-pills may not
be as effective if you are vomiting or have diarrhea. Use another method of
for 7 days after vomiting or diarrhea, even if you have not
missed any pills.
- Raymond EG (2007). Progestin-only pills. In RA Hatcher et al., eds., Contraceptive Technology, 19th ed., pp. 181â€“191. New York: Ardent Media.
- Trussell J, Guthrie KA (2011). Choosing a contraceptive: Efficacy, safety, and personal considerations. In RA Hatcher et al., eds., Contraceptive Technology, 20th ed., pp. 45â€“74. Atlanta: Ardent Media.
- U.S. Food and Drug Administration (2004). Depo-Provera contraceptive injection (medroxyprogesterone acetate injectable suspension). Safety Alerts for Human Medical Products. Available online: ://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm154784.htm.
- Scholes D, et al. (2005). Change in bone mineral density among adolescent women using and discontinuing depot medroxyprogesterone acetate contraception. Archives of Pediatrics and Adolescent Medicine, 159(2): 139â€“144.
Current as of:
November 21, 2017